Comment by Test0129 | Hacker News Reader

Comment by Test0129 | Hacker News Reader

I suppose this comes as no surprise. It almost feels like a conspiracy that With the exception of a few illegal drugs such as meth, heroin and cocaine, the only legal drugs are the ones that arguably carry fairly high risks. Though I suppose the damage from smoking comes mostly from combustion and not the nicotine.

High BMI is such a problem in the west and so trivially preventable. I have family in both medicine and the school system and the number of children who are morbidly obese seems to get higher every year. One thing I've done to pass the time is to count the number of obese people where ever I am. It's relatively shocking that within some margin of error the vast majority of people appear to be obese. Pairing this with the social contagion of "Healthy at Any Size" and we quite possibly have an epidemic worse than anything we have ever seen before. More than just cancer, obesity is expected to surpass heavy alcohol abuse as the #1 cause of severe liver damage.

I am surprised however that chemicals in food weren't studied as a sub-group of the BMI study. Endocrine disrupters are basically everywhere now. A standard western diet is so loaded with garbage.

It's obviously not trivially preventable on the personal level - otherwise people would be losing weight and keeping it off when they try. The reality is that almost everyone really struggles to lose more than about 15 pounds.

Perhaps it would be easy to prevent on a societal level by getting rid of endocrine disruptors, taking junk food out of grocery stores, or something similar.

Well, to be fair, that's partly because the trick is to not become overweight in the first place.

That said I agree. It's clear most people don't have the means and/or ability to do that without policy level help.

Much like the smoking kills campaign it wouldn't be terribly difficult to have a similar campaign for sugar, fake foods, etc. You don't have to eat like a rabbit to stay a healthy weight, but certainly you shouldn't be eating microwave dinners and candy. The problem is sugar itself is analogous to a drug. Moreover, the food lobby is infinitely more powerful than phillip morris could even be in their wildest dreams. We are being poisoned by policy. Unfortunately the solution will remain personal responsibility until our policy makers stop allowing companies to poison us for profit.

The triviality of the solution is that to lose weight you simply eat less. Thermodynamics is all you need for that. 80% of the battle is won and lost here.

The complication is food is designed in laboratories to be addictive as possible. Even vegetables are harvested in such a way they contain extra chemicals and far fewer nutrients. The result is your monkey brain is drawn to Big Gulps and candy because they give you a dopamine release, whereas a steak and vegetables does not. Pair this with food that is deliberately designed to be less satiating and more addicting and you have the recipe for an obesity epidemic.

I think we're mostly agreeing. I do think that calorie for calorie not all foods are equal, and simply eating less is not quite the right thing to focus on. Eating 100 cals of sugar will do different things to your body that 100 cals of protein. Sugar signals the body to store fat. It also makes people crave more food. It is difficult to avoid added sugar these days. I do think people would naturally eat less if there were less sugars in food.

I mean, it's kind of trivially preventable on the personal level:

* Eat mostly non-processed meats/proteins, low-starch vegetables, low-sugar fruits, and non-polyunsaturated cis fats

* Eat high-starch vegetables and high-sugar fruits sparingly

* Generally avoid most other foods

* Generally avoid harmful drugs such as nicotine and alcohol

* Incorporate some light physical activity into your daily routine (walking is an easy one)

* Ideally, lift every now and then

All of this should be within reach of most Americans. If someone accepts it as a viable strategy and commits to it, they can maintain or trend toward a healthy body composition.

Applying this on a societal level seems like a much bigger challenge to me. So much terrible nutritional advice is ingrained in the minds of the public (e.g. the food pyramid), so many terrible dietary choices are normalized and made convenient, and the whole "standard American diet" has so much economic momentum that convincing the public to change their lifestyles all at once might be a disaster in and of itself.

Imagine an alternate reality where the only soft drinks were La Croix and Zevia, McDonald's only served stir-fried meats and veggies with sides of berries, Dunkin' Donuts only served watermelon slices and coconuts, cereals and oatmeals were replaced with low-sugar trail mixes, etc. The obesity epidemic wouldn't exist.

Healthy at any size had a good origin. It was to get young women who saw unrealistic and unhealthy bodies in the media to focus on eating right and exercising rather than focusing on image. It later became an excuse for not doing those things. But the original idea was a positive one.

Adherence to doctors orders for weight loss is so bad most GPs don't even bother anymore. I'm not sure what the answer is.

>the media

A better campaign might have been "ingest less media and listen to general health guidelines."

I think that essentially was the campaign no? "Stop paying attention to places that try to convince you that someone who hasn't even had water for a day just to look a little more chiseled for the shoot is normal and put the fake food in the trash."

I suppose when viewed charitably you could say that healthy at any size had a good origin.

However, the quantifier any is the problem with the entire campaign. It's patently obvious having a BMI > 30 or < 18 is dangerous to your health. Both of these are included at "any" size. The number of grotesquely obese models being shown by fashion companies is having a similar effect that sickly skinny models had. People get the idea that this is normal and ok. Neither is ok, but the literature has shown being a little too thin (not supermodel thin, but marginally underweight) carries less risk than being marginally overweight. Neither are great, but one is measurably worse.

Yeah, while I have more friends who were hospitalized due to eating disorders than obesity, time will change that as we all age.

I do think the larger models are due to obesity actually being the normal now. Not natural, but totally normal. When this many people are obese we need to recognize that simply continuing to say "eat right, exercise more" while correct, isn't working. It isn't like people don't know. Short of authoritarian bans which will inevitably be the wrong diet for some individuals, and get influenced by agriculture and manufacturers, I have no idea what might work.

> High BMI is such a problem in the west and so trivially preventable.

Hardly. Tell that to the 1/3rd Americans who are overweight. If you know the secret to easy weight loss, please don't hold out.

It mostly comes down the the food we eat. Added sugars have made their way into nearly everything you can buy at a grocery store. Buying food that doesn't include added sugars is tricky because nearly everything has added sugar. The evidence that added sugars (especially high fructose corn syrup) are mostly to blame for the obesity epidemic, is becoming overwhelming. Significantly changing what you eat is not easy for everyone.

The biggest change needs to come as regulation to the food industry to discourage adding excessive amounts of sugars to foods. Also, stop subsidizing corn and the production of high fructose corn syrup. Obesity is a systemic problem that needs a systemic solution.

75% of Americans are overweight, and 40% are obese.

There is no secret. The trivial solution is to buy fresh/unprocessed ingredients and cook them yourself. Unfortunately in the land of convenience, cooking has become a chore instead of the enjoyable and rewarding activity that it can be.

I didn't know it was that high. I don't think it is trivial to completely change how one eats. In theory it is a simple solution, but in practice it is hard for people to accomplish.

Really great podcast about standard western diets and some of the affects on gut microbiome, where the guest is a leader of this field in the US:

https://podcasts.apple.com/us/podcast/the-peter-attia-drive/...

>Endocrine disrupters are basically everywhere now.

Anyone have any recent research on environmental factors for obesity, etc.? With microplastics, beverages consumed out of plastic bottle (or plastic coated cans), xenoestrogens, obese pets and wild animals, etc, it wouldn't surprise me at all that we're unknowingly poisoning ourselves.

When I think about it, being low BMI is sort of a FIFO food queue, you wait to use all you stored fat before making some again; being overweight is more a LIFO mode, you carry with you constantly a concentrate of food in you (fat), but still eat more external food. But food is just like any other addiction, possible but hard to reason about

It's also the one addiction where you cannot resolve it by quitting.

People with unhealthy relationships with food actually have to do the work to resolve that. Alcoholics, gamblers, smokers, addicts of all stripes, etc, can just not partake. They never have to confront why they're addicted.

you can quit some bad eating habbits. There was something about the potato diet (which can work with rice, quinoa, ...), if someone have restricted (in choice, not quantity) and unprocessed food, I think there are good chances they'll lose weight

You really discount the mental effort it takes to say NO to your deepest instincts and forgo that creeping urge to eat unhealthy(after all this food tastes good and is designed to release pleasure in the brain). You dismiss all the daily interruptions and stressors that repeatedly tilt the table towards giving into your inner voice.

I wonder if at some point people will start raise the possibility of excluding/restricting access of obese people to socialized/subsidized healthcare unless they commit to loosing weight?

Perhaps, but that would require legislative changes to the Affordable Care Act (Obamacare).

https://www.healthcare.gov/how-plans-set-your-premiums

Why not structure government programs to help people lose weight? Get rid of corn in everything, subsidize healthy fresh food instead of corn. Have centers in each town teaching people nutrition and proper cooking. Make the incentives align with healthy eating and well being.

The medical profession is generally against witholding healthcare from people for sin/moral reasoning. Historically, this has been used to treat black people, gay people, single mothers, poor people, etc. with substandard care and does not lead to population-level good outcomes. Additionally, there is no way to access obese people with the medical processes they may need to lose the weight if the medical field is also systemically depriving them of basic medical care unless they lose weight.

That won't happen.

They will start to tax obesity foods (and in some places already have).

A lot of the reason that industrial food in America has such bad health characteristics is because it's cheaper. Filling things which taste bad because pre-prepaired, frozen, shelf-stable is hard to do with pleasing flavor without taking out most of the water and filling things with sugar, fat, and salt. Making it less affordable will make people make different choices, and scaling up other kinds of foods will make them at least a little cheaper.

...which immediately turns into a tax on the poor, because if you are working three jobs to get by then you have little choice except the cheaper, more readily available "obesity foods".

Reply on news.ycombinator.com